Pediatric photo puzzler: What caused this skin discoloration?

dark spots on skinEvery child with a lemonade stand hopes for hot sunny days to drive in customers. But if your kids squeeze fresh lemons for their stand, make sure they wash their hands after squeezing the lemons. Otherwise, after a sunny day, your child’s hands may turn out looking like the kid’s feet pictured to the left.The juice of some fruits or plants will cause a dark discoloration of the skin if exposed to sunlight. The reaction, called phytophotodermatitis, usually starts a day after the juice comes into contact with the skin. Redness and mild blistering eventually leads into a discoloration which can that can last for months. Citrus fruits are the most common culprits, but wild parsnip, wild dill, wild parsley and buttercups also cause the photosensitivity. Often the initial redness and blistering is missed. The kid in the photo was walking in bare feet on leaves near an apple tree. Makes you almost want to only use powdered lemonade mix…almost.
Naline Lai, MD and Julie Kardos, MD

©2014 Two Peds in a Pod®

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3 Comments

  • Reply Jordan October 13, 2021 at 12:09 pm

    This is not Phytophoto. It’s exogenous pigment from black walnut. Goes away after a few weeks. Could you please change or delete this please? Thank you!

    • Reply twopedsinapod October 13, 2021 at 11:10 pm

      Hello-thought I replied, not sure where it went. I think you are correct, the story was jumping on trampoline with what was thought to be apples parent was not sure-and then sun exposure and appeared. If you are interested,would be great if you want to write a blurb and l can fold it in and repost

  • Reply twopedsinapod October 13, 2021 at 10:47 pm

    Thank you-on reviewing, you are correct. In fact I had a child the other day with black walnut on her hands. The story with this child in the photo was jumping on a trampoline with apple peels and then in sun-and this appeared later-but you are correct.
    Any interest in rewriting it? Can delete this one and repost

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